Keto Diet For High Cholesterol Patients – Even if you are at risk for cardiovascular disease, you may still be a candidate for the popular diet.
For every person talking about the ketogenic diet, there is another warning about its adverse effects on your heart. The concern is that following a diet that is very high in fat, moderate in protein, and very low in carbohydrates will cause subsequent increases in cholesterol levels, which in turn can increase the risk of heart disease.
Keto Diet For High Cholesterol Patients
The concern is certainly valid. On the keto diet, you eat up to 80 percent of your calories from fat and 20 to 50 grams of net carbs each day, a term used in popular diets, including keto and Atkins, but officially recognized diets. has not been (To calculate net carbs, subtract fiber and sugar alcohols from the total carbs per Atkins.) All of this means you’re eating a lot of fat each day, and in the name of meeting this quota, you may include Unhealthy choices. Such as butter, coconut oil and animal fat. All of these are sources of saturated fat, which is linked to poor heart health, according to the American Heart Association (AHA). (The goal of keto is to switch your body from a carb-burning state to a fat-burning state, called ketosis.)
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But the effect of keto on heart health is not as simple as it seems. In fact, the keto diet may not have as detrimental an effect on your cholesterol as previously thought.
“When you review the data, a few things are clear. Looking at population studies and clinical trials, the effect of the keto diet on lipids is very small. Dr. Saffer is a member of the National Lipid Association, an organization dedicated to the management of lipid problems. In October 2019, the National Lipid Association published a statement on low- and very-low-carb, ketogenic diets and their relationship to lipids in the Journal of Clinical Lipidology (PDF). Research generally shows that keto reduces modest In triglycerides, it produces modest changes in heart-protective high-density lipoprotein (HDL or “good”) and minimal changes in low-density lipoprotein (LDL or “bad”). Levels of some studies, review notes, increase LDL is shown on low or very low carb diets (but long term studies are lacking.)
Whether these numbers go up or down—especially HDL—depends largely on the quality of the keto diet. One problem is that there is no such thing as a ketogenic diet. There are different ways to follow it, and some people are careful about the types of fats they eat, while others are not.
According to him, a past paper noted that in human studies of normal-weight and obese subjects, keto diets were generally associated with lower total cholesterol, increased HDL, lower triglycerides, and lower LDL. At the same time, other research, the review points out, shows something different: an increase in LDL or no fluctuation in either direction. The authors note that in the trials that lowered LDL, subjects ate a low-carbohydrate diet with healthy unsaturated fats and limited in unhealthy saturated fats.
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A previous study included in the article above compared a low-calorie, very low-carb, high-fat diet (what constitutes a keto diet) in more than 360 overweight and obese participants. Some participants had diabetes, others did not. After about a year, those in the keto group saw a decrease in total cholesterol, triglycerides, and LDL, while HDL increased.
To find out how the keto diet may be negatively affecting your cholesterol, consider your baseline triglyceride count. According to the Mayo Clinic, triglycerides are another type of fat in your blood that your body uses for energy. The AHA notes that high levels of triglycerides and LDL can lead to fatty deposits that clog arteries. Normal levels are less than 150 milligrams per deciliter (mg/dL). “About a quarter of the population has triglyceride levels above 150 mg/dL, which is the threshold for considering high triglycerides. This is a large percentage of the population, so it’s not uncommon.
If you have normal levels, it’s probably safe to try keto. “For people with normal or perfect triglyceride levels, keto has minimal or no effect,” Saffer says. On the other hand, if you have insulin resistance, type 2 diabetes, and/or abdominal obesity and your triglycerides are elevated—it may seem like you should avoid keto, but the opposite may be true. The low-carb nature of keto has the potential to reduce insulin resistance and improve triglycerides.
Research also shows this effect. A small randomized controlled study published in Nutrition & Metabolism in August 2020 looked at 34 obese seniors over eight weeks. Those on a very low-carb diet lost 3 times the visceral fat compared to the low-fat group. Those on a low-carb diet also had greater improvements in insulin sensitivity, triglyceride levels, and HDL cholesterol.
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In that case, the relationship between triglycerides and HDL cholesterol adds another layer. The AHA notes that when triglycerides are high, HDL is usually low. “Anything that lowers triglycerides also raises HDL,” Saffer says. Remember, HDL is the “good” cholesterol that removes some LDL from the bloodstream and transports it to the liver, where it can be metabolized and disposed of, according to the AHA — so raising HDL is ultimately good for the heart. You are useful.
The study only included 34 people—so more research (especially larger, longer-term studies) is needed before scientists can fully understand the true effects of keto on insulin resistance and triglycerides.
A larger set of studies of 567 people with diabetes, pooled from more than 13 studies in a November 2020 meta-analysis in Nutrition and Diabetes, found that following a ketogenic diet reduced fasting blood glucose and — in eight studies – It also reduces HbA1c level. measuring average blood sugar over time). On average, HbA1c was reduced by about 1.5%. Research shows that a 1% reduction in HbA1c can reduce the risk of heart attack by 14%, the authors point out.
But in general, research is mixed when it comes to using keto for fat loss or weight loss. One important note: There isn’t enough data to show whether keto can produce long-term results. As a previous review noted, weight loss on keto peaks at five months, followed by slow weight regain. And a meta-analysis of 38 studies in the December 2020 issue of Nutrients that compared low-carb diets with low-fat diets concluded that each had different effects on the body, but only in the short term. Low-carb diets were associated with greater weight loss (about 3 pounds) and better HDL and triglyceride numbers than low-fat diets. On the other hand, low-fat diets more effectively reduced LDL and total cholesterol. However, these results were only valid for the short term, and the few studies that looked at results after two years found that the results were no longer significant, possibly because people had trouble with it in the long term.
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The effect of eating high fat and very low carbohydrates on your LDL is not so clear. As the AHA says, LDL is the type of cholesterol associated with hardening of the arteries, which can increase the risk of heart disease and stroke. It may go up, down, or stay relatively constant. According to Saffer, if you have normal triglyceride levels and use keto to lose weight, your LDL may stay the same. Similarly, if you have high triglycerides to begin with and that number comes down on keto, your LDL may remain the same.
The bottom line is that keto alone may not contribute to the cholesterol spikes that some people report when starting the diet. But if you start eating more saturated fat because of keto, your LDL is likely to increase. According to Saffer, increasing saturated fat intake has been shown time and time again to raise LDL.
Where things get potentially dangerous is if you’re one of those people who has an inherited genetic mutation that affects how LDL particles are regulated. “If these people follow a keto diet, their LDL levels can skyrocket,” Saffer says. This result doesn’t happen often enough to change the overall results in population studies, but what matters most is the effect of diet on your individual health. “It’s a long-known phenomenon that’s not well publicized,” he says, adding that the genetics that drive this response are not fully understood. (The APOE gene may be one, but probably not the only gene.)
You may not know that you have a preexisting genetic mutation, also called familial hypercholesterolemia (FH). In fact, as the AHA points out, only 10 percent of people with FH know they have it. Knowing your family history, including members who had a heart attack at a young age, is important and can help point your provider in the right direction. In some cases, research suggests that a low-carb diet may actually be beneficial for people with FH who also have insulin resistance. This is not something you can bother yourself with. Instead, it’s just another reason
